DUR Result of Service

Claims reversed because of a DUR advisory message must have an accompanying standard “DUR Result of Service Code” value submitted. These values allow HHSC to measure the effectiveness of advisories and document action taken by the pharmacist. Refer to the Claims Billing Reversal (B2) Transaction for specific transaction, segment, and field requirements.

Field Name Field Number Accepted Values
DUR Result of Service Code 441-E6

1C - Filled with a different dose
1D - Filled with different directions
1E - Filled with a different drug
1F - Filled with a different quantity
2A - Prescription not filled
2B - Not filled, directions clarified

This value must be submitted on reversals caused by a DUR message because the Centers for Medicare & Medicaid Services (CMS) requires all state Medical programs to demonstrate positive results from online ProDUR. Pharmacy providers should contact their software vendor for questions relating to the appropriate submission of these codes on reversal transactions.